Vitamin B12 is an essential micronutrient required for optimal hemopoetic, neuro-cognitive and cardiovascular function. If you face a serious problem maintaining glucose, taking a vitamin B12 injection for almost 3 months will help you bring things in balance. 2012;122:25370, 5. diabetes mellitus; diabetic neuropathies; malabsorption; metformin; prediabetic state; syndromes; vitamin B12. Vitamin B12 deficiency exists among patients with diabetes in the setting discussed. We conducted a cross-sectional study among patients attending Princess Marina diabetes clinic in Gaborone between July 2017 and October 2017. 2016;134:4739, 22. Natural Medicines. Pflipsen M, Oh R, Saguil A, Seehusen D, Seaquist D, Topolski R. The prevalence of vitamin B12 deficiency in patients with type 2 diabetes: A cross-sectional study J Am Board Fam Med. Associations between B12 deficiency and age, duration of type 2 diabetes mellitus (T2DM), duration of use and dosage of metformin, and use of proton pump inhibitors (PPIs) were determined. You can boost the absorption of vitamin B12 in your body by taking the following medications: 1- An antibiotic- known as chloramphenicol. Vitamin B1: Aids the breakdown of carbohydrates.Vitamin B2 Aids the metabolism of carbohydrates, protein, and fat.Vitamin B3 Aids the metabolism of carbohydrates, fat, and alcohol.Vitamin B5 Aids the metabolism of carbohydrates, protein, fat, and alcohol.Vitamin B6 Aids the metabolism of carbohydrates and protein.More items Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Abstract Background Metformin is first-line therapy for patients with diabetes. Well, vitamin B12 does not play a role in the management of blood glucose levels. Metformin Use Increases Vitamin B12 Deficiency in Patients With Diabetes The dose and duration of metformin is linked with vitamin B12 deficiency, which have implications for planning screening or prevention strategies in patients with diabetes. National Library of Medicine privacy practices. Measuring methylmalonic acid or homocysteine concentrations in patients with borderline vitamin B12 deficiency may have increased the prevalence of vitamin B12 deficiency in our study. If it remains unchecked, you will also experience symptoms of peripheral neuropathy in diabetic neuropathy. Keywords: So, it was not possible to get a valid estimate of the deficiency prevalence. Diabetic patients should choose a diet that contains B12, else they will face a severe deficiency of this vitamin. include protected health information. Unauthorized use of these marks is strictly prohibited. [2] The prevalence of diabetes in Saudi Arabia alone has increased to reach 7 million cases. In this study, we aimed to evaluate the prevalence of vitamin B12 deficiency in patients with chronic metformin use and the relationship between vitamin B12 deficiency and diabetic neuropathy. Unauthorized use of these marks is strictly prohibited. A large percentage of physicians are not aware of the current recommendations of the ADA regarding vitamin B12 supplementation and screening. The mean serum vitamin B12 level of all 16 patients was 558.46 318.01 pg/mL (range of 1741288 pg/mL). Taylor & Francis does not sell reprints or permissions for this article. Approval was taken from and approved by the Institutional Review Board of MoH. The most commonly used oral hypoglycemic agent was gliclizide only in 138 (38.4%) of patients. We assessed vitamin B12 status using serum vitamin B12 levels. It was thought that the use of PPI contributes to vitamin B12 deficiency,[32] which may add to the vitamin B12 deficiency status of T2DM patients. J. Clin. https://www.wolterskluwercdi.com/facts-comparisons-online/. We wanted to determine the prevalence of vitamin B12 deficiency in metformin-treated type 2 diabetes mellitus patients. Methylcobalamin. Compared with participants with normal Vitamin B12 levels, deficient participants were significantly older (64 vs. 56 years, p=0.014) and had a longer duration of metformin use (7 vs. 4 years, p=0.024). You may also suffer from diabetic neuropathy due to a lack of vitamin B12. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Hunt A, Harrington D, Robinson S. Vitamin B12 deficiency Bmj. Review/update the 2019 Aug;69(Suppl 3)(8):S40-S44. 2017Last accessed on 2019 Jan 28 Available from: 3. 2014;127:816, 23. Vitamin B12 status and peripheral neuropathy in patients with type 2 diabetes mellitus. We presented continuous variables as mean (standard deviation [SD]) or median (interquartile range [IQR]) as appropriate. Clinical Implications of the Coexistence of Anemia and Diabetes Mellitus in the Elderly Population. Keyword Highlighting To estimate the prevalence of Vitamin B12 deficiency among patients with diabetes. Standards of medical care in diabetes Diabetes Care. When there is incomplete absorption of vitamin B12 from food, your body will be deficient. You can control blood glucose level in your body by increasing intake of vitamin B12. official website and that any information you provide is encrypted Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Treatment Of B12 Deficiency In Diabetes Patients. Accessed Jan. 9, 2021. The prevalence of vitamin B12 deficiency in patients with type 2 diabetes: a cross-sectional study, Association of biochemical B12 deficiency with metformin therapy and vitamin B12 supplements: the national health and nutrition examination survey, 19992006. Weight Both are confounders for vitamin B12 deficiency as they are known to decrease the excretion rate of cyanocobalamin which could result in a higher serum level. On the contrary, this study also highlighted that a large number of our physicians are not aware or updated with the current recommendations of ADA regarding vitamin B12 supplementation and vitamin B12 screening for T2DM patients on metformin. Though vitamin B12 is commonly taken to increase energy levels, evidence showing that B12 supplements improve energy levels in people without a deficiency is lacking. Patients were given a single tablet of B vitamins containing 2.5 milligrams of folic acid, information highlighted below and resubmit the form. Of all the patients 17 were already considered to be deficient in B12. In this study an inverse correlation was found between diabetic neuropathy and the plasma level of vitamin B12. Taking this diabetes drug might reduce your body's ability to absorb vitamin B-12. Intramuscular injections are the best choice to deal with absorption problems. All prospective diabetic patients were identified from the diabetic care clinic records including the Vitamin B12 levels. Associations between B12 deficiency and age, duration of T2DM, duration of use and dosage of metformin, and use of proton pump inhibitors (PPIs) were determined. eCollection 2019. In diabetes, blood glucose level goes low beyond a certain limit. Gastritis is due to either Helicobacter pylori (H. pylori) infection or autoimmune mechanisms.Citation41,Citation42 H. pylori infection prevalence within the geriatric population is as high as 70% to 85%, while autoimmune atrophic gastritis is about 20-fold higher in the elderly than in the general population.Citation43 Another reason for the high prevalence of vitamin B12 deficiency in the elderly is the high rate of acid blocker prescriptions.Citation39,Citation40, In the current study, increased but low haemoglobin levels were significantly associated with vitamin B12 deficiency. One such major complication is damage to nerves due to very high blood glucose levels for a long period. This can happen if you don't eat Am J Clin Nutr. eCollection 2020. People with diabetes type 1 are usually at higher risk of getting autoimmune disorders like thyroid problems and coeliac disease. J. Clin. The cumulative dose of metformin during the study period is not an accurate reflection of the dose taken/compliance as a pill count (counting returned tablets) or prescription filling was not correlated, and hence the resultsshowing no significant difference between the sufficient and deficient B12 groupsshould be interpreted with caution. Biochemical B 12 deficiency was defined as serum B 12 concentrations 148 pmol/L and borderline deficiency was defined as >148 to 221 pmol/L. WebVitamin B-12 deficiency anemia is a condition in which your body does not have enough healthy red blood cells, due to a lack (deficiency) of vitamin B-12. World Health Organization. Association between metformin and vitamin B. Metformin: Sex/Gender Differences in Its Uses and Effects-Narrative Review. Cited by lists all citing articles based on Crossref citations.Articles with the Crossref icon will open in a new tab. Diabetes Metab. Thus, you can take an intramuscular injection to boost the absorption of vitamin B12 in the blood. E-mail: [emailprotected]. Problems concentrating. Keywords: Cobalamin Diabetes mellitus Metformin Would you like email updates of new search results? Consult your doctor to analyze the blood sample report to assess the level of essential vitamins and minerals. Table 2 shows factors associated with Vitamin B12 deficiency among diabetes patients at Princess Marina Hospital diabetes clinic on bivariate analyses. J Pak Med Assoc. It has been suggested that healthy people can have low levels of vitamin B12, and much more vitamin B12 deficiency commonly occurs in around 6% of elderly patients aged 60 years with prevalence increasing with age. Aims To compare the prevalence of vitamin B12 deficiency and peripheral neuropathy between two groups of type 2 diabetes mellitus (T2DM) patients treated with or without metformin, and to determine factors associated with vitamin B12 deficiency therapy and dietary intake of vitamin B12. However, you can prevent the B-12 deficiency by taking a proper diet and supplements. Descriptive statistics (frequency distribution) was done for the responses from the physicians. The mean daily dose of metformin was 984.85 320.96 mg (range: 5002000 mg). Allen LH. information and will only use or disclose that information as set forth in our notice of Careers. Moreover, the risk of vitamin B12 deficiency also increases with increased metformin dose and duration of its use. We defined vitamin B12 deficiency as serum B12 levels < 150pmol/l.Citation15,Citation16 Anaemia was defined as Hb < 13g/dl for males and < 12g/dl for females.Citation17 Macrocytosis was characterised as mean corpuscular volume (MCV) > 100fl.19.Citation18. Another limitation is that we could have collected/determined the homocysteine levels, holotranscobalamin, methylmalonic acid, and red blood cell B12 of the patients, which could have helped us determine if there is true tissue deficiency of vitamin B12, that will help us determine vitamin B12 deficiency when no laboratory determination of serum vitamin B12 level is available. Nervo M, Lubini A, Raimundo F, Moreira Faulhaber G, Leite C, Fischer L, et al Vitamin B12 in metformin-treated diabetic patients: A cross-sectional study in Brazil Rev Assoc Med Bras. Most (89.5%) participants were on metformin. Even though it has known efficacy and favorable safety profile, there are reported side effects such as vitamin B12 malabsorption. Careers. Dr. Braden G. Barnett is an endocrinologist in Los Angeles, California and is affiliated with multiple hospitals in the area, includingKeck Medical Center of USCandUSC Norris Comprehensive Cancer Center. -, Aroda VR, Edelstein SL, Goldberg RB, Knowler WC, Marcovina SM, Orchard TJ, Bray GA, Schade DS, Temprosa MG, White NH, et al. The countries in the MENA region now have some of the highest rates of diabetes. Epub 2015 Sep 4. This is the first study to estimate the prevalence of vitamin B12 deficiency in a diabetes clinic in Botswana to the best of our knowledge. 1- Does vitamin B12 is crucial for lowering blood sugar? 2011;57:469, 11. de Groot-Kamphuis DM, van Dijk PR, Groenier KH, Houweling ST, Bilo HJ, Kleefstra N. Vitamin B12 deficiency and the lack of its consequences in type 2 diabetes patients using metformin Neth J Med. WebGeneral physical symptoms of vitamin B12 deficiency can include: Feeling very tired or weak. 2014;29:96572, 13. de Jager J, Kooy A, Lehert P, Wulffele M, van der Kolk J, Bets D, et al Long-term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency: Randomised placebo-controlled trial BMJ. There are some limitations of this current study. The mean duration of metformin use was 9.84 7.29 years (range: 1.035 years). [78910111213] Geographical studies conducted in the United Kingdom, Iran, Spain, China, and Mexico all showed significant association between long-term use of metformin and vitamin B12 deficiency. Meat consumption in Botswana increased by 0.3% between 1966 and 2011, primarily driven by beef, poultry and pork consumption.Citation22 The variation in the cut-off values for vitamin B12 deficiency across studies may also explain the wide variations in B12 deficiency from 5.8% to 52% in studies worldwide.Citation5,Citation6,Citation8,Citation10,Citation19,Citation20,Citation2325 In some studies, individuals with borderline vitamin B12 levels were further screened for evidence of elevated serum methylmalonic acid or homocysteine concentrations.Citation2 In this way, patients with borderline vitamin B12 levels were further categorised into those with or without vitamin B12 deficiency. ; syndromes ; vitamin B12 deficiency also increases with increased metformin dose and duration of Its use of... 122:25370, 5. diabetes mellitus in the management of blood glucose level in your body 's to... 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